Authors

Disclosure statement

Martin Williams is president of PRISM (https://prism.org.au), a not-for-profit organisation that facilitates psychedelic research in Australia, and Scientific Officer of Mind Medicine Australia (www.mindmedicineaustralia.org), a charity established to support psychedelic research to achieve positive mental health outcomes, and to provide relevant education and training for future clinicians in the field.

Stephen Bright is vice-president of PRISM, a not-for-profit organisation that facilitates psychedelic research in Australia (http://prism.org.au)

Australia needs a paradigm shift in the way we treat mental illness. Scientific research is increasingly pointing to psychedelic drugs like psilocybin and MDMA (methylenedioxymethamphetamine, more commonly known as Ecstasy) as viable options.

While social stigma and academic conservatism have seen Australia lag behind other countries in this area of research, we are on the cusp of the first Australian trial of psychedelic drugs for mental health.

This research is going to look at psilocybin-assisted therapy for anxiety and depression among terminally ill patients.

A brief history of psychedelic drugs

Psychedelics are a broad category of drugs that can produce profound changes in consciousness. “Magic mushrooms”, containing psilocybin, have been used by some indigenous communities for at least 1,000 years. Other psychedelics, such as LSD and MDMA, were first synthesised in the laboratories of major pharmaceutical companies early in the 20th century.

In the 1950s, psychedelics were considered “wonder drugs”, used with psychotherapy in treating a range of conditions. These included depression, end-of-life anxiety, post-traumatic stress disorder (PTSD) and alcohol dependence.

But, in the 1960s, psychedelics escaped the clinic and became popular among the younger generation. In response to their association with the counterculture movement, a moral panic ensued. Psychedelic drugs were made illegal internationally in 1971.

Research and practice were abandoned, until recent shifts in attitude led to the re-emergence of medical research using psychedelics.

Some people will take antidepressants for many years.From shutterstock.com

In 2013, we wrote a piece in The Conversation about this international psychedelic science renaissance.

How psychedelics work in the brain

We’re now beginning to understand the neurological mechanisms responsible for the mystical states and creative thinking psychedelics can produce, and how they can aid the treatment of anxiety and depression.

Psychedelics reduce the activity of a neural circuit in the brain called the default mode network (DMN).

The DMN is responsible for our “resting state” sense of self, which can become distorted as depression and similar mental illnesses take hold. By temporarily decreasing the activity of the DMN, psychedelics appear to enable other less direct neural pathways to be established.

The mechanism of this process is not yet understood, but it seems to correlate well with the demonstrated positive mental health outcomes of psychedelic-assisted psychotherapy.

On the other hand, various health conditions for which psychedelics are not suitable are widely recognised. In particular, people with underlying personality disorders or psychiatric conditions such as schizophrenia risk worsening of their symptoms.

People who have medical conditions such as heart or liver disease, or who are using a wide range of medications including antidepressants, are also advised to avoid psychedelics without careful medical supervision.

Meanwhile, a newly established charity, Mind Medicine Australia, is aiming to negotiate Australia’s regulatory framework to have psychedelics reclassified from the most restrictive drug category to one that accommodates prescription medicines.

If the results of our study, and those of others around the world, confirm the promise of the initial trials already completed, there is an excellent chance several of these treatments will be approved for prescription use within three to five years.

But, as well as proving the efficacy of these treatments, we will need to continue to demonstrate their safety, negotiate regulatory hurdles and ultimately convince doctors and the public that psychedelic psychotherapy is a viable approach for mental health treatment.

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THE CANADIAN PRESS/Jonathan Hayward